AB0974 Association between diabetes mellitus as part of metabolic syndrome and osteoarthritis (preliminary data)
Authors: L. Alekseeva, E. Taskina, N. Kashevarova, D. Kusevich, K. Telyshev, E. Strebkova, E. Sharapova, D. Kudinsky, O. Alekseeva, N. Demin, O. Tenkova, E. Kharlamova, A. Abolyoshina
Journal: Annals of the Rheumatic Diseases (2022)

Background There are more evidence that diabetes mellitus (DM) aggravates the course of osteoarthritis (OA). Objectives At multicenter study to evaluate impact of DM as part of metabolic syndrome on course of knee OA. Methods The enrolled patients had knee OA based on ACR criteria with x-ray confirmation with stage I-III (Kellgren and Lawrence (K&amp;L). Mean disease duration was 5 (2-10) years. Patients were evaluated by report form, using the anthropometric parameters, questionnaires, disease history and comorbidity, clinical examination data, assessment of knee joints pain, standard X-ray, ultrasound signs of OA, DXA three sites the L1-L4 lumbar spine, femoral neck, and total hip. All participants were signed an informed consent form. Results At prospective study were enrolled 253 women with mean age 58.3 ± 9.5 years (40-75) years, with knee OA. Compensated DM type 2 was diagnosed in 26 (10.3%) patients with knee OA. All patients with knee OA were divided into two groups:1st group was with DM and 2nd group without DM (Table 1). Patients with DM were older, had higher weight and BMI. In patients with DM was harder course of OA based on clinical and instrumental data: higher pain by WOMAC score; at X-ray were more frequent confirmed III stage (K&amp;L) (ОR=3.1, 95%CI 1.1-8.7, р= 0.01). At X-ray investigation narrow of medial joint space and at ultrasound thickness of the cartilage were also smaller at 1st group (р&lt;0.05). Bone mineral density (BMD) in site total hip was also higher at DXA at 1st group. More often comorbidity at 1st group was hypertension (OR=3.5 (95%CI 1.2-10.6), р= 0.01), metabolic syndrome (MS) (OR=10.2 (95%CI 2.3-44), р=0.0002) and nonalcoholic steatohepatitis as part of MS (OR=33.9 (95%CI 3.22-356.8), р=0.003). Table 1. Comparative characteristics of patients with OA with or without DM. Parameters 1 group (n=26) 2 group (n=227) p Age, years, Me 65.5 (60- 68) 59 (52- 65) 0.002 BMI, кg/m2, Me 33.5 (29.4- 35.8) 28.7 (25.6- 32.3) 0.0006 OA duration, years, Ме 11 (7- 18) 4 (2-10) 0.0032 Generalized ОА, % 50 24.5 0.009 WOMAC pain, mm, Ме 199 (158- 230) 120 (45- 190) 0.005 X-ray stage (K&amp;L), % I 8.7 32.5 0.04 II 65.2 57.3 III 26.1 10.2 Medial knee joint space, mm, Ме 2 (0.6- 3.1) 3.4 (2.2- 4.5) 0.03 Cartilage thickness in posterior-lateralis area of knee joint, mm, Ме 1.5 (1.4-1.7) 1.7 (1.6- 1.9) 0.05 HbA1c, %; Ме 7.2 (5.4-7.7) 5.4 (5-5.7) 0.01 Glucosae, mmol/l, Ме 6.6 (5.1-6,9) 5.3 (4.9- 5.7) 0.003 Hypertension, % 84.6 60.8 0.01 Metabolic syndrome, % 92.3 54.2 0.0002 Medial knee joint space, mm, Ме 2 (0.6- 3.1) 3.4 (2.2- 4.5) 0.03 Cartilage thickness in posterior-lateralis area of knee joint, mm, Ме 1.5 (1.4-1.7) 1.7 (1.6- 1.9) 0.05 BMD total hip, g/cm2, Ме 0.966 (0.955-1.054) 0.878 (0.801-0.944) 0,04 Number of components of MS, % 0 0 21.1 0.0009 I 10.5 32.8 II 47.4 36.7 III and more 41.2 9.4 Nonalcoholic steatohepatitis, % 18.8 0.8 0.003 In the Spearman correlation analysis are confirmed positive associations between DM and more difficult and prolonged course of OA. We found out that higher WOMAC pain subscale (r=0.18), total hip BMD at DXA (r=0.25), smaller size of medial joint space (r=-0.24) and thickness of the cartilage at ultrasound (r= -0.13) are associated with DM (р&lt;0.05 for all parameters). Positive relationships also are indicated with BMI (r=0.21), hypertension (r=0.15), MS (r=0.24), type, such as nonalcoholic steatohepatitis (r=0.26) and number of components of MS (r=0.39). Conclusion The patients with OA are high frequent comorbidity with DM (10.3%). Association OA and DM lead to severe OA and higher comorbidity. References None Disclosure of Interests None declared